Aging Increases Risk of Cervical or Vaginal Cancer

Women’s health screenings and precautions are advertised heavily in today’s world. In particular, pap smears and HPV vaccines are highly recommended during visits to the gynecologist. However, what happens when abnormalities are found after a pap smear? One potential finding from these screenings is a pre-malignant or pre-cancerous state called cervical intraepithelial neoplasia or CIN.

If a woman is found to have CIN, she does not have cancer, but the cells lining the surface of her cervix have transformed into abnormal forms that could eventually lead to cancer. CIN is graded depending on its severity and location. Grade 3 is the most severe form of CIN and is the last stage before cancer develops. Treatment involves surgical removal or destruction of the abnormal cells. Removing these cells does not necessarily mean that the risk of cancer has been eliminated.

In a recent study published in the British Medical Journal, Swedish researchers found that women previously treated for CIN grade 3 have a more than doubled risk of dying from cervical or vaginal cancer compared with women in the general population. Specifically, they identified aging as a primary risk factor for getting and/or dying from cervical or vaginal cancer in women previously treated for CIN3. The higher a woman’s attained age, particularly after the age of 60 or 70, and the higher the age at initial treatment, the greater the risk of acquiring or dying from cancer. This means that if you were diagnosed and treated for CIN3 at the age of 55, for instance, you are at a greater risk of developing cancer than a woman who was diagnosed and treated at the age of 40.

The investigators identified 150,883 women from the national Swedish Cancer Registry who were diagnosed with CIN grade 3 during the time period 1958-2008. Of these women, they determined that 1089 had also been diagnosed with cervical cancer and 147 with vaginal cancer. Of those diagnosed with cancer, 302 died of cervical cancer and 53 died of vaginal cancer. Calculations of the increased relative risk of getting and/or dying from cervical or vaginal cancer were made for women diagnosed with CIN grade 3. Statistics revealed that the incidence of cervical or vaginal cancer in these women was greater than 70 per 100,000 women at 70 years of age compared to 8.9 per 100,000 women in the general population.

What this means for you: If you were previously diagnosed with and treated for cervical intraepithelial neoplasia grade 3 (CIN3), discuss long term management and cancer screenings with your doctor beyond the recommended 25 years of follow-up. This study shows that risks of developing cervical or vaginal cancer in women treated for CIN3 increase with advanced age and should be monitored until old age.